Validity and reliability of telephone administration of the patient-specific functional scale for the assessment of recovery from snakebite envenomation

Objectives: Although more than 1.8 million people survive snakebite envenomation each year, their recovery is understudied. Obtaining long-term follow-up is challenging in both high- and low-resource settings. The Patient-Specific Functional Scale (PSFS) is an easily administered, well-accepted patient-reported outcome that is validated for assessing limb recovery from snakebite envenomation. We studied whether the PSFS is valid and reliable when administered by telephone. Methods: This is a secondary analysis of data from a randomized clinical trial. We analyzed the results of PSFS collected in-person on days 3, 7, 14, 21, and 28 and by telephone on days 10, 17, and 24. We assessed the following scale psychometric properties: (a) content validity (ceiling and floor effects), (b) internal structure and consistency (Cronbach’s alpha), and (c) temporal and external validity using Intraclass Correlation Coefficient (ICC). Temporal stability was assessed using Spearman’s correlation coefficient and agreement between adjacent in-person and telephonic assessments with Cohen’s kappa. Bland Altman analysis was used to assess differential bias in low and high score results. Results: Data from 74 patients were available for analysis. Floor effects were seen in the early post-injury time points (median: 3 (IQR: 0, 5) at 3 days post-enrollment) and ceiling effects in the late time points (median: 9 (IQR: 8, 10). Internal consistency was good to excellent with both in-person (Cronbach α: 0.91 (95%CI 0.88, 0.95)) and telephone administration (0.81 (0.73, 0.89). Temporal stability was also good (ICC: 0.83 (0.72, 0.89) in-person, 0.80 (0.68, 0.88) telephone). A strong linear correlation was found between in-person and telephone administration (Spearman’s �: 0.83 (CI: 0.78, 0.84), consistency was assessed as excellent (Cohen’s κ 0.81 (CI: 0.78, 0.84), and Bland Altman analysis showed no systematic bias. Conclusions: Telephone administration of the PSFS provides valid, reliable, and consistent data for the assessment of recovery from snakebite envenomation

Women and mobile: a global opportunity - a study on the mobile phone gender gap in low and middle-income countries

Executive summary Mobile phone ownership in low and middle-income countries has skyrocketed in the past several years. But a woman is still 21% less likely to own a mobile phone than a man. This figure increases to 23% if she lives in in Africa, 24% if she lives in the Middle East, and 37% if she lives in South Asia. Closing this gender gap would bring the benefits of mobile phones to an additional 300 million women. By extending the benefits of mobile phone ownership to more women, a host of social and economic goals can be advanced. Mobile phone ownership provides distinct benefits to women, including improved access to educational, health, business and employment opportunities. Women surveyed across low and middle-income countries on three continents believe that a mobile phone helps them lead a more secure, connected and productive life. This survey has also found that: From India to Senegal to Kosovo, women are using the power of mobile phones to unlock economic opportunities Women business owners in particular perceive the phone as an essential productivity tool, with more than half saying they have used a mobile phone to earn additional income 85% of women report feeling more independent because of their mobile phone